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urothelial carcinoma

Wednesday 28 September 2016

transitional cell carcinoma

WKP PO

Types

- non-invasive urothelial carcinoma

-  invasive urothelial carcinoma

Variants

- glandular urothelial carcinoma
- microscystic urothelial carcinoma
- micropapillary urothelial carcinoma
- nested urothelial carcinoma
- lymphoepithelioma-like urothelial carcinoma
- small tubules urothelial carcinoma
- inverted urothelial carcinoma
- sarcomatoid urothelial carcinoma
- small cell urothelial carcinoma
- rhabdoid cell urothelial carcinoma
- lipoid-rich cell urothelial carcinoma
- trophoblastic urothelial carcinoma
- osteoclast-rich urothelial carcinoma
- plasmacytoid urothelial carcinoma
- clear cell urothelial carcinoma
- gial cell urothelial carcinoma

Immunochemistry

- positive IHC

  • CK7, CK20 (50%), HMW keratin (80%)
  • GATA3
  • uroplakin (40-60%, but highly specific),
  • thrombomodulin (Am J Surg Pathol 2003;27:1),
  • variable p63
  • MUC1, CEA, p53, S100
  • Variable CA125 (Int J Biol Markers 1994;9:224), variable HER2
  • CD31, CD34, and podoplanin (D2-40) are useful to distinguish true lymphatic invasion from retraction artifact, particularly in micropapillary variant

Note: keratin may stain non-tumor cells in repeat biopsy cases (Am J Surg Pathol 2007;31:390)

Note: CK20 staining pattern in primary tumor is replicated in metastases (Arch Pathol Lab Med 2001;125:921)

- negative IHC

  • prostatic markers PSA, P501S, PSMA, NKX3.1 and pPSA (Am J Surg Pathol 2007;31:1246)
  • WT1, MUC2, MUC5AC (Am J Clin Pathol 2004;122:61), HPV, Leu7/CD57

See also

-  carcinomas

Open references

- Histological variants of urothelial carcinoma:
diagnostic, therapeutic and prognostic
implications. 2009. https://www.nature.com/modpathol/journal/v22/n2s/pdf/modpathol200926a.pdf

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